Resolution #1 Postpone legislative action on the enhanced nurse licensure compact: 2016 MNA Convention--October 4, 2016.
Whereas, The Montana Board of Nursing (BON) successfully passed the NLC through the 2015 legislature and was implemented October 1, 2015; and
Whereas, In May 2015, the National Council of State Boards of Nursing
(NCSBN) adopted two new Compacts: the "enhanced" Registered Nurse (RN) Compact and the Advanced Practice RN (APRN) Compact; and
Whereas, Any state in which the original NLC has been adopted will necessitate repealing the original compact legislation and submitting new legislation for the "enhanced" Compact; and
Whereas, The enhanced Compact is based on standards that the NCSBN identifies as:
(1) required criminal background checks both state and federal, on initial licensure, and
(2) restriction from acquiring a multistate license if ever convicted of a felony. Additionally, the enhanced Compact must include the NCSBN's Uniform Licensure Requirements establishing initial endorsement, renewal and reinstatement licensure requirements which must be adopted by all Compact states; and
Whereas, In 1998, the American Nurses Association (ANA) with the full support of the Montana Nurses Association, took the position that the location of practice is where the RN is located, given the knowledge, skill, and judgment applied to practice rests with the RN, and ANA's position on the state of practice was reaffirmed by the 2015 Membership Assembly, that included MNA Representatives; and
Whereas, The MNA/ANA and the NCSBN have a fundamental difference of opinion concerning the location of practice; and
Whereas, This concern affects state sovereignty, and the variations and disparity in licensure would be confusing and burdensome for RNs, due to the following:
* Frequency and requirements for re-licensure and re-registration;
* Recognition of non-traditional education programs, particularly with regard to number of clinical hours required for entry into practice;
* Required continuing education, if any;
* What will constitute an infraction and resultant actions taken by the BON;
* Criminal background checks (CBC);
* As of June 2015, 36 states require CBC, 20 of the 25 NLC states require a CBC. Of the 14 states that do not require fingerprint-based CBC, 5 require a state record search for information on past criminal history by name checks and state court records and 9 states require self-disclosure of any criminal history;
* Scope of Practice;
* Is there a program for addressing RN diversions and addictions;
* Ensuring compliance and regulation by compact RNs.
Whereas, MNA has and will continue to communicate its ongoing legislative platform driven by its RN membership that is opposed to the NLC in its' current form largely due to license jurisdiction and the diversity among practice, licensure and re-licensure requirements; and
Whereas, There is currently a model being discussed as a third option to the nursing compacts by an NCSBN/ANA workgroup, with MNA representation with the goal of a formal report in December 2016; now therefore, be it
Resolved, That MNA desires to advocate with the BON addressing the noted concerns that impact our state, our citizens and our RN professionals and collaboratively bring forward nurse compact licensure that makes sense for Montana;
Resolved, That MNA will continue to oppose the enactment of the enhanced nurse compact in its' current form until the report on the third option is disseminated by the NCSBN/ANA workgroup; and
Resolved, That MNA will oppose any legislation that negatively impacts state sovereignty concerning nurse licensure and regulation.
Resolved, That MNA/ANA will continue to focus on moving forward with related areas of critical concern that will contribute to creating an environment that will support interstate care delivery by striving for standardization of licensure processes across the state jurisdictions that will preserve autonomy for the states;
Resolved, That MNA/ANA will review policy, legal and legislative trends that are used toward identifying license jurisdiction;
Resolved, That MNA will continue to support the regulatory authority and collaborate with the BON on nursing practice issues.
Submitted by MNA Board of Directors Passed unanimously by 2016 MNA House of Delegates on 10/7/2016